title: Clinical outcome of sorafenib treatment in patients with advanced hepatocellular carcinoma refractory to hepatic arterial infusion chemotherapy.
abstract: OBJECTIVE
  It has been reported about poor prognosis in patients with advanced hepatocellular carcinoma (HCC) refractory to hepatic arterial infusion chemotherapy (HAIC). We assessed the survival benefits of sorafenib therapy for advanced HCC in HAIC refractory patients.
  
  
  METHODS
  The study subjects were 191 patients with advanced HCC who had been treated with HAIC. Sorafenib was used in 27 patients who finally failed to respond to HAIC (HAIC/sorafenib group). Clinical outcome was compared between HAIC/sorafenib and HAIC alone groups.
  
  
  RESULTS
  There were no significant differences in clinical characteristics and response rate of HAIC between the two groups (response rate: 25.9%, HAIC/sorafenib group; 30.4%, HAIC alone group). The median survival time (MST) for all patients was 11.0 months. The survival rate was significantly higher in the HAIC/sorafenib group than HAIC alone group (MST 22.2 vs 8.7 months, P = 0.017). From administration sorafenib, the disease control rate was 51.8% with MST of 10.4 months. Among HAIC non-responders, the survival rate was significantly higher in the HAIC/sorafenib group than HAIC alone group. Multivariate analysis identified additional therapy with sorafenib as significant and independent determinant of overall survival in all patients and HAIC non-responders.
  
  
  CONCLUSIONS
  Additional therapy with sorafenib could probably improve the prognosis of HAIC refractory patients.
authors.affiliation: Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Miyaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Aikata
authors.forename: Hiromi
authors.initials: H
authors.lastname: Kan
authors.forename: Hatsue
authors.initials: H
authors.lastname: Fujino
authors.forename: Ayako
authors.initials: A
authors.lastname: Urabe
authors.forename: Keiichi
authors.initials: K
authors.lastname: Masaki
authors.forename: Takayuki
authors.initials: T
authors.lastname: Fukuhara
authors.forename: Tomoki
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Noriaki
authors.initials: N
authors.lastname: Naeshiro
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakahara
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Kawaoka
authors.forename: Akira
authors.initials: A
authors.lastname: Hiramatsu
authors.forename: Shoichi
authors.initials: S
authors.lastname: Takahashi
authors.forename: Masaki
authors.initials: M
authors.lastname: Ishikawa
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kakizawa
authors.forename: Kazuo
authors.initials: K
authors.lastname: Awai
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000473:pathology; D004341:Drug Evaluation / Q000379:methods; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009536:Niacinamide / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D010671:Phenylurea Compounds / Q000008:administration & dosage* / Q000009:adverse effects; D011379:Prognosis; D012189:Retrospective Studies; D000077157:Sorafenib; D016019:Survival Analysis; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D010671:Phenylurea Compounds; D009536:Niacinamide; D000077157:Sorafenib
keywords: HAIC; HCC; prognosis; response; sorafenib